Provider Demographics
NPI:1033398268
Name:DAS, ASISH K (MD)
Entity Type:Individual
Prefix:DR
First Name:ASISH
Middle Name:K
Last Name:DAS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 5000
Mailing Address - Street 2:UNIT 65
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-5000
Mailing Address - Country:US
Mailing Address - Phone:503-494-4910
Mailing Address - Fax:503-494-8368
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:MAILCODE UHS-2
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-494-4910
Practice Address - Fax:503-494-8368
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD22750207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR067400Medicaid
R111004Medicare PIN
F84105Medicare UPIN